Insights

The Impact of HHGM

Posted on Friday, August 25, 2017 4:11 PM

It has been over a month since the proposed rule was released and many agencies are scrambling to understand the impact to their organization. The deadline for commentary on the proposed rule is fast approaching, one month from today, on September 25th . Please make sure your voice is heard.

It is important that you take the time to understand how this impacts your organization. At Corridor, we have begun the cross-walk process with the proposed rule to gain further insight on how agencies will be affected both financially and operationally under the HHGM compared to the current PPS. It is clear to us that this will dramatically affect all aspects of an agency’s business if put in place as it stands today. Thus far, we have found some ICD-10 codes that were used as primary diagnosis’s will be considered questionable encounters in the new model and the episode would be returned to the provider for more accurate or definitive coding. Agencies will need to identify what type of encounters these are and how often they are currently being used. Wage models will need to be evaluated by MSA and reimbursement will clearly be affected by patient acuity and based upon where the referral is coming from, the community or institution. Agencies that have a high number of therapy visits will also want to understand how eliminating therapy services from the new payment model may impact their reimbursement.

Minimally, this will increase and perhaps double the number of invoices you will need to process. Clearly, this makes it all the more important that you have strong billing and collections processes in place today.

For more information about HHGM or Billing and Collections, please call Amanda Gartner at 701-347-2448.

Written by Mary Morrisey Gabriel, Vice President of Marketing and Innovation.